The checkup surprises Ramirez, who is far more concerned with Shannon’s body fat percentage.

“The weight is not devastating, the thing that is rocking my boots here is the body fat: 40 percent,” he tells her. “Almost half of your body has converted to fat. Half. It’s the stuff that kills people. 40 percent, we’re sprinting to diabetes, we’re sprinting to cardiovascular disease. At 50-plus [years old] with these numbers? It is a huge red flag.”

“We have some work to do,” he adds.

Shannon, understandably, doesn’t take the information lightly — and holds back tears as she strips down to her sports bra for photos.

“I just don’t understand how I let myself go,” she confesses to the audience, finally breaking down in tears and explaining that she was never more than a size 4 her whole life. “When I look at myself in the mirror, I don’t know who I am. I don’t like to do it. I don’t look because I don’t know who it is.”

FROM PEN: Half Their Size: Ashley O’Reilly Was Inspired by a Friends Weight Loss

She also reveals her frustration over the criticisms that have come her way over the past few months. “People say, ‘Oh you have too many fillers.’ No it’s called f—ing weight gain,” she says. “They say, ‘Did you have a boob job?’ Not it’s called weight gain.”

The Real Housewives of Orange County airs Mondays (9 p.m. ET) on Bravo.